The present study examined the efficacy of a theory-based intervention designed to positively influence physical activity (PA) behavior in a group of pediatric cancer survivors. Ten survivors participated in a 16-week PA intervention that targeted the main theoretical tenets of the theory of planned behavior (TPB). Survivors were followed over a course of 1 year and completed measures of attitudes, subjective norms, perceived control, intentions for PA, and self-reported PA behavior at five different times. While the magnitude of change varied across the key theoretical constructs, it appears that the intervention had a small yet meaningful impact, particularly for overall behavioral intentions. Overall, this study provides preliminary data to suggest that the TPB may be a viable framework from which to build interventions for pediatric cancer survivors. Future research will be required to further identify and target the key elements and theoretical constructs within a behavioral intervention.
Melanie R. Keats and Nicole Culos-Reed
Cadeyrn J. Gaskin, Melinda Craike, Mohammadreza Mohebbi, Kerry S. Courneya and Patricia M. Livingston
The ENGAGE (efficacy of a referral and physical activity program for survivors of prostate cancer) study established that a clinician referral and 12-week exercise training program increased vigorous physical activity at 12 weeks among men with prostate cancer. Here, we report the 6- and 12-month outcomes.
In this multicenter cluster randomized controlled trial, we compared a clinician referral and exercise training program to usual care. Discounted gym membership was offered to men in the intervention condition on completion of the 12-week exercise program. Self-reported physical activity at 6 and 12 months was the primary outcome. Quality of life, anxiety, and depressive symptoms were secondary outcomes.
A total of 147 men meeting eligibility criteria agreed to participate (54 intervention, 93 control). A positive interaction effect for vigorous physical activity was observed at 6 months, but not 12 months. No significant effects for the secondary outcomes were found.
A clinician referral and community-based supervised and unsupervised exercise training program, along with discounted gym membership, had a positive short-term effect on vigorous physical activity levels, but did not improve quality of life, in men with prostate cancer.
Laura Q. Rogers, Kerry S. Courneya, Steven Verhulst, Stephen J. Markwell and Edward McAuley
Our aim was to assess differences in exercise counseling preferences, program preferences, and telephone/Internet access among breast cancer survivors based on exercise behavior and demographic, medical, social cognitive, and environmental factors.
A self-administered survey was returned by 192 breast cancer survivors.
Participants were Caucasian (98%), and the mean age was 64 ± 11.5 years. Participants preferring an exercise specialist were more likely to report current treatment, higher self-efficacy, greater perceived barriers, and a residential environment conducive to physical activity. Participants preferring face-to-face counseling and exercising outdoors were younger, and those preferring to exercise alone and at home reported lower social support. Low-intensity exercise was preferred by participants who were sedentary, obese, less self-efficacious, enjoyed exercise less, perceived greater barriers, and reported lower social support. Participants with Internet access were more apt to be younger with higher income and greater social support.
Demographic, medical, social cognitive, and environmental factors might influence exercise preferences and Internet access. Future research assessing the effectiveness of tailoring interventions based on these factors is warranted.
Laura Q. Rogers, Stephen Markwell, Patricia Hopkins-Price, Sandy Vicari, Kerry S. Courneya, Karen Hoelzer and Steven Verhulst
To better understand mechanisms of physical activity (PA) behavior change in breast cancer survivors, we examined mediation of a successful PA behavior change intervention by social cognitive theory (SCT) constructs. Our exploratory study randomized 41 breast cancer survivors to receive the 3-month intervention (INT) or usual care (UC). We used the Freedman and Schatzkin approach to examine mediation of intervention effect on PA 3 months postintervention by changes in SCT constructs from baseline to immediately postintervention. Compared with UC, the INT group reported lower barriers interference (mean difference = −7.8, 95% CI [−15.1, −0.4], d = −0.67, p = .04) and greater PA enjoyment (mean difference = 0.7, 95% CI [0, 1.5], d = 0.61, p = .06). Barriers interference mediated 39% (p = .004) of the intervention effect on PA 3 months postintervention. PA enjoyment was not a significant mediator. Reducing barriers to PA partially explained our intervention effect.
Maria Laura Resem Brizio, Pedro C. Hallal, I-Min Lee and Marlos Rodrigues Domingues
The aim of this study was to investigate the association between lifetime physical activity and risk of lung cancer.
A case-control study was conducted in southern Brazil. Case subjects were recruited from oncology services of 4 hospitals. Control subjects were selected from the same hospitals, but from different services (traumatology and emergency). Both case subjects (n = 81) and control subjects (n = 168) were interviewed using a questionnaire about sociodemographic characteristics, anthropometric information and family history of cancer. Control subjects were matched to case subjects according to sex and age (± 5 years). Detailed information on smoking was collected. Physical activity was measured using the Lifetime Physical Activity Questionnaire.
Of the case subjects, 89% were either current or former smokers; among control subjects, this value was 57%. Participants in the second, third, and fourth quartiles of all-domains physical activity had odds ratios of 0.54 (95% CI, 0.21–1.40), 0.25 (95% CI, 0.08–0.72), and 0.24 (95% CI, 0.07–0.83) for lung cancer, compared with the lowest quartile, after adjusting for confounding. In the fully adjusted models, leisure-time physical activity was not associated with lung cancer risk.
Lifetime all-domains physical activity may reduce the risk of lung cancer.
Shirley M. Bluethmann, Wayne Foo, Renate M. Winkels, Scherezade K. Mama and Kathryn H. Schmitz
Oncology position statement on obesity and cancer . Journal of Clinical Oncology, 32 ( 31 ), 3568 – 3574 . doi:10.1200/JCO.2014.58.4680 10.1200/JCO.2014.58.4680 Mama , S.K. , Foo , W. , Winkels , R. , Wiskemann , J. , Bluethmann , S.M. , Calo , W. , … Schmitz , K.H. ( 2018 ). Rural
Shaunna M. Burke, Jennifer Brunet, Amanda Wurz, Christina Butler and Andrea Utley
. , & Beulertz , J. ( 2013 ). Clinical exercise interventions in pediatric oncology: A systematic review . Pediatric Research, 74 ( 4 ), 366 – 374 . PubMed doi:10.1038/pr.2013.123 10.1038/pr.2013.123 Baxter , P. , & Jack , S. ( 2008 ). Qualitative case study methodology: Study design and
Mette Rørth, Tine Tjørnhøj-Thomsen, Prue Cormie, John L. Oliffe and Julie Midtgaard
the negative effects observed by previous researchers. Furthermore, a recent debate among leading exercise-oncology researchers ( Hardcastle & Cohen, 2018 ) emphasized the importance of the active involvement of clinicians in exercise promotion among cancer survivors, and indicated that clinicians
Nathan H. Parker, Rebecca E. Lee, Daniel P. O’Connor, An Ngo-Huang, Maria Q.B. Petzel, Keri Schadler, Xuemei Wang, Lianchun Xiao, David Fogelman, Richard Simpson, Jason B. Fleming, Jeffrey E. Lee, Ching-Wei D. Tzeng, Sunil K. Sahai, Karen Basen-Engquist and Matthew H.G. Katz
-based exercise program concurrent with preoperative treatment for pancreatic cancer. Pancreatic cancer treatment represents an understudied context in exercise oncology research, and there exists significant potential to improve treatment and quality of life outcomes. 32 Given the challenges of age, disease
Kelley Strohacker and Cory T. Beaumont
adults ( Strohacker, Fazzino, Breslin, & Xu, 2015 ), rehabilitation ( Boggenpoel, Nel, & Hanekom, 2018 ), Type 2 diabetes treatment ( Delevatti et al., 2019 ), and exercise oncology ( Fairman, Zourdos, Helms, & Focht, 2017 ). It is interesting that recent criticisms directed toward classic behavior